Wang ZhiDong, Zhu RuoFu, Yang HuiLin, Shen MinJie, Wang Genlin, Chen Kangwu, Gan Minfeng, Li Mao
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, China.
BMC Musculoskelet Disord. 2015 Oct 12;16:290. doi: 10.1186/s12891-015-0746-4.
Anterior cervical discectomy and fusion is the golden standard for anterior surgery treating elderly cervical degenerative disease, but the previous implant has some problems such as looseness, translocation, sinking and dysphagia, So Zero-p implant and PCB implant have been developed to decrease the complications.
The clinical data of 57 patients with single level cervical spondylotic myelopathy were retrospectively analyzed. 27 patients adopting Zero-p interbody fusion cage as implant (Zero-p group) and 30 patients adopting integrated plate cage benezech (PCB) as implant (PCB group) from January 2010 to October 2012. Observe whether are differences between the two groups of patients on operation time, intraoperatve blood loss,Japanese Orthopaedic Association (JOA) scores before and after operation, intervertebral height, cervical physiological curvature, fusion rate, Postoperative dysphagia rate and complications.
Zero-p group's operation time is 98.2 + 15.2 min and its intraoperatve blood loss is 88.2 + 12.9 ml, both of which are lower than those of PCB group (109.8 + 16.9 min,95.2 + 11.6 ml ), so their differences are statistically significant (P < 0.05). The two groups' JOA scores 3 months after operation and in the last follow-up are significantly higher than those before operation, so the differences are statistically significant (P < 0.05). Coob angle 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05). The two groups' operation segments intervertebral height 3 months after operation and in the last follow-up improves obviously compared with before operation, so the difference is statistically significant (P < 0.05) Zero-p group has one patient with dysphagia after operation and PCB group has four patients with dysphagia after operation, so there is no statistical differences between the two groups on dysphagia rate (P > 0.05, P = 0.415). PCB group has two patients with screws backing out and two patients with hoarseness after operation, the two groups' operation segments all saw bony union in the last follow-up. Zero-p group postoperative complications are lower than PCB group (P < 0.05, P = 0.044).
Zero-profile implant and PCB implant both achieved good clinical effects on the treatment of cervical spondylotic myelopathy, the two groups both saw bony union in operation segments, but Zero-profile implant has the advantages of easy operation, short operation time, less intraoperatve blood loss and less complications.
颈椎前路椎间盘切除融合术是治疗老年颈椎退变性疾病前路手术的金标准,但以往的植入物存在松动、移位、下沉及吞咽困难等问题,因此研发了Zero-p植入物和PCB植入物以减少并发症。
回顾性分析57例单节段脊髓型颈椎病患者的临床资料。2010年1月至2012年10月,27例患者采用Zero-p椎间融合器作为植入物(Zero-p组),30例患者采用一体化钢板融合器(PCB)作为植入物(PCB组)。观察两组患者在手术时间、术中出血量、术前及术后日本骨科协会(JOA)评分、椎间高度、颈椎生理曲度、融合率、术后吞咽困难发生率及并发症方面是否存在差异。
Zero-p组手术时间为98.2±15.2分钟,术中出血量为88.2±12.9毫升,均低于PCB组(109.8±16.9分钟,95.2±11.6毫升),差异有统计学意义(P<0.05)。两组术后3个月及末次随访时的JOA评分均显著高于术前,差异有统计学意义(P<0.05)。术后3个月及末次随访时的颈椎Cobb角较术前明显改善,差异有统计学意义(P<0.05)。两组手术节段术后3个月及末次随访时的椎间高度较术前明显改善,差异有统计学意义(P<0.05)。Zero-p组术后有1例患者出现吞咽困难,PCB组术后有4例患者出现吞咽困难,两组吞咽困难发生率差异无统计学意义(P>0.05,P=0.415)。PCB组术后有2例患者出现螺钉松动,2例患者出现声音嘶哑,两组手术节段在末次随访时均见骨融合。Zero-p组术后并发症低于PCB组(P<0.05,P=0.044)。
Zero-profile植入物和PCB植入物在治疗脊髓型颈椎病方面均取得了良好的临床效果,两组手术节段均见骨融合,但Zero-profile植入物具有操作简便、手术时间短、术中出血量少及并发症少等优点。